Family History Assessment and the Impact on Breast Cancer Diagnosis

The breast surgical nurse navigator and high-risk breast program (HRBP) advanced practice provider noticed a significant number of women, with a family history of breast cancer, coming through the organizations multidisciplinary breast cancer program (MDBP). These women should have been referred to the HRBP for validated risk assessments and screening recommendations based on family history of breast cancer, or a prior personal history of breast cancer diagnosed before age 50. Obtaining an accurate family history at each encounter with the patient is instrumental in identifying women who might qualify for enhanced screening and monitoring. Identifying women for high-risk screening can in turn detect breast cancer at an earlier stage, resulting in less aggressive treatment and better overall outcomes for the patient.

A retrospective review of the women seen in the MDBP identified an educational opportunity regarding the importance of screening patients to identify the need for a risk assessment. Identifying high risk patients before the development of a breast cancer, provides the opportunity for earlier interventions, which has the potential to ultimately decrease the amount of treatment indicated. This approach would then potentially result in less invasive treatment and decreased morbidity and mortality for the patient.

Three hundred and twelve women diagnosed with breast cancer went through the MDBP at Deaconess Hospital, Inc. in 2024. Of those women, 142 had a family history of breast cancer that would have qualified them for a referral to the HRBP for formal risk assessment prior to their cancer diagnosis.

A total of 46% of patients that were seen in the MDBP in 2024 qualified for high risk assessment for breast cancer based on retrospective review of family history. Had these patients been assessed prior to their diagnosis of breast cancer, it is possible that they would have qualified for increased breast screening resulting in earlier diagnosis and decreased need for treatment interventions. Improvement in obtaining and documenting an accurate family history at each patient encounter helps to identify patients at increased risk for developing a breast cancer.